Analysis of Influencing Factors and Evaluation of Clinical Efficacy of Prophylactic Elective Cervical Cerclage in Patients with Cervical Insufficiency

doi:10.3969∕j.issn.1674-3245.2026.01.020

Abstract：Objective To investigate the influencing factors of prophylactic elective cervical cerclage in patients with cervical insufficiency and to observe the clinical application effect. Methods A retrospective study was conducted on 165 patients with cervical insufficiency admitted to the Maternal Hospital of Qinhuangdao from January 2018 to December 2020. All patients received prophylactic elective cervical cerclage. According to the survival status of newborns, the patients were divided into successful group (129 cases) and failure group (36 cases). The clinical data and auxiliary examination indicators of the two groups were compared to evaluate their impact on surgical outcomes. Results Among the 165 patients, 129 survived in the successful group, with a surgical success rate of 78.18%. The average gestational age extended by 16.82±5.66 weeks in the successful group, while it was 4.66±1.22 weeks in the failure group. The causes of surgical failure included persistent vaginal bleeding in 4 cases, placental abruption in 3 cases, puerperal infection in 15 cases, uncontrolled uterine contractions in 7 cases, and suture detachment in 7 cases. Univariate analysis showed that hospitalization times, cerclage gestational age, combined with gestational hypertension, cervical length, and assisted reproductive technology had differences (P<0.05); while age, body mass index (BMI), hospitalization days, number of abortions, number of full-term deliveries, cervical internal os width, whether cervical conization had been performed, combined with scarred uterus, combined with uterine fibroids, white blood cell count (WBC), C-reactive protein (CRP), and interleukin 6 (IL-6) levels showed no statistical significance (P>0.05). Logistic regression analysis showed that cerclage gestational age >20 weeks and assisted reproductive technology were the main influencing factors for patients with cervical insufficiency undergoing prophylactic elective cervical cerclage (P<0.05). Conclusion Prophylactic elective cervical cerclage shows significant effects in treating cervical insufficiency, significantly increasing gestational age and improving the success rate of the procedure. However, it should be noted that when the gestational age exceeds 20 weeks or when the patient has undergone assisted reproductive technology, the clinical efficacy of this prophylactic measure will significantly decrease.